Testing
by clp66
Summary: A continuation from Not Alone where Susan undergoes a number of trials as she works with Dr. House's team.
1. Chapter 1

A/N: This story is a sequel to "Not Alone" Story ID: 6576430 and picks up several weeks later. Please enjoy.

Chapter One:

"Beep, Beep, Beep…." The alarm went off and Susan opened her eyes. Reaching her hand out from under the covers, she pressed the snooze button to quiet the alarm and looked at the clock. Squinting her eyes to focus, she saw that the time was 5:30am. Groaning, she rolled over and sat up in bed. "Ouch" she said to herself. She was still a little sore from surgery a couple of weeks ago. For the most part it didn't bother her, but in the early morning as she sat up, the stiffness from not moving all night would cause her abdominal muscles to complain a little. A warm shower would wake her up and help with the stiffness. She got up out of bed and grabbed her robe she had draped over her desk chair. As she walked into her bathroom, she heard her alarm go off again. She hung her robe on the towel rack and walked back in her room to turn off the alarm. As she went back into the bathroom she wondered if Greg – Dr. House, she'd better start calling him that again – was getting up and around. "Probably not," she thought to herself, he didn't strike her as much of an early riser. Her dad was like that – up most of the night and preferred to sleep in whenever possible. The military didn't really allow for that, but after he retired, he enjoyed "his beauty sleep" as he called it.

Today was to be her first day back to work after surgery. She was recovering nicely and Dr. Chase had finally released her to return. It had taken a little longer to recover than they had anticipated because she had donated the larger lobe of her liver to Dr. House. But now her enzymes were all normal and her jaundice was gone. Besides, he had told her, they had gotten spoiled with her running the labs for them and the fellows were all clamoring for her return. She smiled at that thinking back to the resentment that some of the fellows had shown her when she had first come to work for Dr. House. "I'm glad I was missed," she told him, "shows that I was contributing something positive for the team."

Susan finished getting ready, ate a light breakfast and headed out the door. She made her way toward Princeton Plainsboro and as she was driving down a residential street, she saw – "surely not" she said to herself. Dr. House was walking toward the hospital. She pulled up next to him and rolled down her window.

"Hey good lookin', need a lift?" she said. Dr. House got into her jeep and she continued toward the hospital. "Why are you walking to work?" she asked.

"Car broke down several blocks back and the batteries are dead on my cell phone." He answered

"Well, I'm glad I came this way this morning then, it's too cold to be walking. You don't charge your phone overnight?" she asked.

"Aren't you full of questions this morning? I was occupied and it didn't cross my mind," was his answer.

Susan smiled; she knew why he was occupied. "How is the family by the way?" she asked

"Not a family, but everybody is fine." He replied.

"Why not?" She asked.

"Why not, what?" Dr. House asked.

"Why aren't you a family? You're there more often than you are at your own apartment," Susan asked.

Dr. House didn't answer and stared out the window in silence the rest of the way to work. Susan pulled up to the doors of the hospital to let Dr. House out of her jeep. As she came to a stop, she heard Dr. Chase, "Curb-side service?"

"Perks of being the boss." was the reply.

Susan smiled and pulled away to find a parking place. She was a fairly new employee and low on the totem pole; she had to park at the end of the lot. It was quite a walk to the front doors and it was freezing outside. No way was she going to make Dr. House walk the distance from the lot to the front doors.


	2. Chapter 2

Chapter Two:

Susan stomped her feet at the entry of the hospital to knock off the snow before walking inside. She really hated the cold. That was the one thing she missed about West Texas. It still got cold there, but it wasn't anywhere nearly as cold as New Jersey. Of course, New Jersey didn't suffer from 105 degree weather in the summer either; she guessed it was an even trade. As she made her way toward her lab, she saw Dr. Wilson.

"Good morning, Dr. Wilson," she said.

He answered politely and then said, "You brought Dr. House in this morning."

"I saw him walking on the street. His car broke down and his phone battery was dead." She said.

"I wonder if this will finally push him to get a new car," Dr. Wilson mused. "He's been driving that same car for 15 years."

"I've been driving mine for nearly 10 years. It's paid for and it's hard to think about having another car payment, especially while I'm trying to put my daughter through college.

"Dr. House doesn't have that excuse," was the reply.

"True. See you around," Susan said as she continued to the lab.

Susan walked in the lab, took off her coat and looked around the lab. Everything was exactly as she left it. She knew the fellows had used the lab while she was away, but knowing her type A personality, they had made a point to put everything back where it belonged. She slipped on her lab coat, walked over the chemistry analyzer, opened the lid and looked around. It was past time for monthly maintenance and sure enough, they hadn't done it for her. There was build up on the reagent probes and the filters were dirty. She got out the equipment she needed to start the maintenance when she noticed a note on her work table. "HR at 9" was written in large letters and in Dr. House's handwriting, it was 8:45. "Great," she thought. "I wonder what that is all about." She took off her lab coat, washed her hands and headed out the door to HR.

"You lied," was the first thing she heard when she walked into the HR director's office. Dr. House was standing in the back of the room and was looking directly at her. Susan's heart skipped a beat and she felt her face go pale.

"No I haven't. What are you talking about?" she said.

"On your application," this time the comment came from the director of HR motioning for her to sit down.

"I didn't lie on my application," Susan stated simply.

"You did. You stated specifically that you didn't have any relatives working at the hospital," the director said.

"Oh," Susan replied as she sat down. "Well, technically it wasn't a lie, but I can see why you might think differently. Dr. House and I are not really siblings, I mean – there is a biological connection, but we're not siblings. We didn't grow up together, we have different parents; we didn't play games, fight in the car or argue like real siblings. Yes, we have a common biology – but we didn't know that, at least I didn't, until recently. I wasn't even 100% sure it was true until after I came for my interview and saw him and that was well after I filled out the application." Susan turned to look at Dr. House, "I didn't lie." House nodded his acknowledgement.

"Okay, given your explanation I'm not obligated to dismiss you for falsification of your application, but the hospital nepotism policy is clear on family relationships within hospital staff," the director said. "No relative is allowed to work under the supervision of another relative."

"But it's OK for supervisors to date their employees?" Susan asked and instantly regretted it. She didn't want to cause problems for Drs. House and Cuddy, it just slipped out.

"That situation has fallen under a different policy at the hospital, and has been handled accordingly," the director said.

"So, I have to leave?" Susan asked.

"No," Dr. House jumped into the conversation. "You're going to report to Dr. Wilson, but you'll still be a part of my team."

"So, I'll still do what you say, but Dr. Wilson will be my supervisor. It's an administrative thing." Susan stated. Both the director and Dr. House nodded. At that point, Susan could see that this subject had been discussed at length between the two and this was the arrangement they had finally agreed. Dr. House had gone to bat to keep her, not only at the hospital, but on his team as well. She was grateful and she needed this job. It paid better than research and still allowed her to use her brain for more than just following basic procedures day after day.

As Susan and Dr. House walked out of HR, she said, "Thank you for going to bat for me and I'm sorry I mentioned yours and Dr. Cuddy's relationship. I don't know what I was thinking; it just popped out before I could stop it."

"I'd rather you speak your mind than keep silent," he said. They got into the elevator and Dr. House pressed the floor button.

"Does everybody know about us?" Susan asked, "I didn't mean for this to become public knowledge; I can see where it might be a source of embarrassment for you."

"The last thing I worry about is what other people think," House replied. "But no, the knowledge is limited to my team, Drs. Cuddy and Wilson and of course the HR director. Your blood type match to me was just a happy, or not so happy, coincidence as far as the rest of the hospital staff is concerned." They exited off the elevator and as they got closer to his office, Susan veered off to the left. "Where are you going?" Dr. House asked.

"To see Dr. Wilson; if he is going to be my supervisor now, I probably need to check in with him," Susan answered.

"Nope," House said, "You don't work for him."

"I'm confused." Susan said.

"Wilson is responsible for your reviews; you still work for me." Dr. House explained. "Come on, we have a case."


	3. Chapter 3

Chapter Three:

Dr. House's fellows were already gathered around the conference table looking over copies of the patient file. Susan sat down at the table and grabbed the remaining file sitting on the table and Dr. House went over to get himself some coffee. Looking around the table, Susan asked, "Where's Dr. Hadley?"

"Gone," replied Taub. "She's taking a leave of absence," he continued.

"Oh," Susan replied, "I hope she's OK."

House interrupted and looked directly at Susan, "As much as we would all like to know what is going on with 13, it's not relevant to our patient." House picked up his marker and stepped over to the white board. "What do we know?" he asked.

Foreman started the differential by listing the symptoms that brought the patient to Dr. House. "The patient was transferred from Princeton General. He is in his mid-fifties and initially presented with weakness and chills. Additionally, his mother has complained that he has had total body severe diaphoresis for the last couple of months. Most recently he has suffered acute renal failure."

"I'm sorry," interrupted Susan, "what is 'diaphoresis?"

Taub answered, "Excessive sweating."

"Thank you," Susan replied.

"Usually, it's not just sweating," said Dr. House, "generally it's accompanied with shock or other medical emergencies. What do we know about the patient history?"

Chase answered this question, "The patient has had atrial fibrillation, deep vein thrombosis, and hypertension. Additionally, he's obese and has acid reflux disease. Currently, he is on Warfarin, Cardizem and Nexium to treat those conditions."

Dr. House started writing. "So we have, 'weakness', 'fat', 'sweats', 'shivers', and 'no PeePee'. Go." The fellows started listing off possibilities. Dr. House said, "Susan, go pull his blood so we can have up to date chemistries. Run a CMP and add Magnesium, LD and CK. The rest of you, do a more thorough physical exam and get an MRI of his abdomen." Everybody got up to tend to the patient, when House spoke again, "Susan, stay here for a minute. I have something for you." Susan stayed behind and followed House into his office. He pulled several sheets of paper out of file and handed them over.

Susan looked over the paperwork, "Oh, proficiency testing. I guess it's that time…Crap! This is due tomorrow!" she exclaimed. How long have we had the specimens?"

"A couple of weeks; they're in your lab fridge" Dr. House replied.

"Did you guys have a case last week?"

"No." was the reply.

"Then why didn't somebody run them?" she asked.

"It's your test," Dr. House replied.

"No, it's the lab's test to make sure that everything is running properly, it doesn't matter who runs them."

"It does to me – it's your lab, it's your test. Go do your job." House ordered.

"This is just great! The specimens have sat, and I have to get it all done in one day – I'm probably going to fail! This is a crappy way to start my first day back!" Susan exclaimed as she turned to walk out the door.

"Make sure you get the patient done first" House said as Susan started to leave.

"Duh," Susan said sarcastically, "Patient's always come first." House smirked at her behind her back as she stormed out the door. Susan grabbed her phlebotomy supplies, calmed her rapidly deteriorating attitude and went to see the patient. "Hello Mr. Purdue, how are you today?" The patient just stared at her and said nothing.

An aged woman answered for him, "I'm sorry ma'am. He doesn't speak much to strangers. He's mentally retarded and strangers scare him. It might help if you call him by his first name, 'Andy'"

"Oh, I see," said Susan. Susan made a mental note to add that piece of information to the white board. She didn't recall seeing his mental state listed in his patient file, but she could have overlooked it. Susan sat down on a stool next to Andy and spoke gently, "Andy, my name is Susan."

Andy looked at her phlebotomy tray and stared at the contents. His eyes grew wide and he asked, "What are you doing to do with that stuff?"

"Well," Susan said, "Your doctors have asked me to take some of your blood so we can find out what is wrong with you. Do you understand?"

Andy said, "I already know what is wrong with me."

"What's that?" Susan asked.

Andy looked around the room to see if anybody was listening and then whispered, "My pee pee doesn't work."

"Oh, I see," said Susan. "Well, we have to figure out why it doesn't work and I need some of your blood so we can figure it out so we can make you better. Would you let me take some blood out of your arm?"

Andy nodded that it was OK, and Susan readied her supplies. She tied the tourniquet around his arm and prepared the needle to draw blood. As soon as Andy saw the needle, he panicked. "No!" he yelled, "No shots!" He flung his arm toward Susan and knocked her back sending the needle flying. Susan lost her balance and fell, landing on top of the needle. "OW!" she cried out. Drs. Taub and Chase were coming into the room and saw what had happened through the glass. Chase rushed over and picked Susan up off the floor while Taub tried to calm Andy down. Chase saw the needle sticking out the back of Susan's thigh and pulled it out.

"Are you OK?" he asked.

Tears were starting to form in her eyes from the pain in her leg, but Susan held them back. "I'm fine." She said. Chase looked at the needle in his hand and looked at Susan. "Don't worry," she said. "I hadn't stuck him with it yet – it was sterile."

A look of relief came over Chase's face. "Good," he said. "After all you've been through lately; I wouldn't want you to have the added worry of blood borne pathogen testing hanging over your head. How do you feel?"

"He hit me pretty hard on my arm and left side, but I'm OK. I need to draw his blood so I can run the tests."

The elderly lady come over to Andy and spoke gently to him, "Andy sweetheart, we need you to hold still so the nice lady can take your blood."

"She wants to hurt me Mom." Andy replied.

"No," she continued, "she doesn't want to hurt you; she just needs to get some blood from your arm. Please hold still." With Chase and Taub assisting by holding the squirming Andy down, Susan was able to draw enough blood for the tests. Susan left and went to the lab.

In the lab Susan was finally able to finish the monthly maintenance on the instrument and started preparing her quality control samples. "What a start to my first day back," she thought to herself as she rubbed her arm. She pulled two vials out of the refrigerator, her 5mL volumetric pipette and bulb and purified water. She had just pulled up 5mL of water into the pipette and started dispensing the water into one of the vials when Dr. Wilson came into the lab behind her back. "Hey!" Susan jumped with a start causing her to knock over her vial spilling the contents onto the cabinet. Wilson continued, "Since I'm your supervisor, don't you think it's appropriate for you to check in with me when you come in?"

Susan closed her eyes for a moment, took a calming breath and gathered her temper. The day was getting better and better by the moment, Susan thought sarcastically. Not saying anything, she threw away the control sample vial and cleaned up the mess. She took off her gloves and her lab coat, went over to the sink and washed her hands. Looking at Dr. Wilson she said, "Come with me." Perplexed, Wilson followed her out of the lab and down the hall to the elevator. She said nothing while they were in the elevator and she walked straight into Dr. House's office and stood in front of his desk. Dr. House looked at her over his reading glasses inquisitively. "You two need to talk. I'll be in the lab when you figure it out." Susan walked out of Dr. House's office and went back to the lab leaving Drs. Wilson and House staring at her back.

"What did you do to piss her off?" House said to Wilson.

"Nothing," he replied. "I startled her when I walked in the lab though and she knocked over a sample vial. I just asked her why she hadn't come to see me yet since I was her supervisor now."

"You're not her supervisor," House replied.

"I seem to recall otherwise because of the nepotism policy." Wilson said.

"No," said House, "she's still on my team. You're just handling her reviews."

"How am I supposed to evaluate her for her reviews if she doesn't check in with me?" Wilson asked.

"Fine," said House. "She can check in with you, but she's still on my team."

"You've gotten attached to her haven't you?" Wilson said.

"She's a good tech and a valuable member of my team." House deflected.

"And it has nothing to do with her being your new found little sister." Wilson accused. "I want her to come by my office every morning to update me on what is going on. Other than that, she is still part of your team." House nodded his agreement and Wilson dropped by the lab to talk to Susan.


	4. Chapter 4

Chapter Four:

Andy's specimen was finally on the analyzer for the tests that Dr. House had ordered. Another half hour or so and the tests would be finished. As the tests were running, Susan prepared the proficiency testing specimens for analysis. She entered the information into the laboratory information system and printed out the barcode labels she needed for the sample tubes. This proficiency test series was only for chemistry, hematology and immunology. She knew that in the not distant future she would get another set of specimens for microbiology, but since she was off of leave she would be able to get them as soon as they arrived and she would have more time to work them up than just one day. As she finished printing the last label, Andy's results came off. She looked at the results to make sure that everything had run properly then she verified the results in the laboratory information system. As soon as she verified the results, the report started printing. She printed off four more copies of the lab results and headed up to the conference room.

Nobody was in the conference room; she guessed they were with Andy running the abdominal MRI. Dr. House was not in his office, though she doubted he was with the patient. This was a blessing as she really needed to work on the proficiency test specimens. She set the lab results down and sent a text to Dr. House indicating that the blood work was finished and the results were on the conference room table. She went back down to the lab.

MRI completed, the fellows and Dr. House all gathered in the conference room. Dr. House waited for somebody to start talking. "Is somebody planning on telling me something or are we all just going to sit here looking stupid?"

"We're waiting on Susan," Taub said.

"She's working on her proficiencies; she left the lab results for us. We don't need her to read the results us." House explained. Each of the fellows picked up a copy of the lab results and looked them over.

Taub had conducted the more thorough physical exam and started with the results from that. "After the episode with Susan, I did his physical exam…," he started.

"What episode with Susan?" House interrupted.

"When she started to draw his blood, the patient panicked and struck out. He knocked her to the floor, but she was able to draw his blood with Chase and I holding him down.

"And?" House asked, concerned but keeping his face neutral.

Chase interjected, "She said he hit her pretty hard on her left side but when she fell, she landed on the vacutainer needle. She said she hadn't stuck him yet, so the needle wasn't contaminated with his bodily fluids."

"OK, continue," House ordered turning his attention to Taub.

Taub continued, "He was cold and shivering and he had 4 blankets over the top of him – but those four blankets were soaked with perspiration, so he's still alternating between sweating profusely and then getting chilled. He has an irregular heartbeat, but his lungs are clear. He has no tenderness in his abdomen and no swelling in his extremities.

House was writing on the white board when Chase took over the conversation, "The MRI showed no adenopathy (swelling of the lymph nodes). The internal organs all looked normal and there were no adrenal masses."

Foreman was looking at the lab results, "His creatinine, BUN, glucose and ALT are all elevated and his albumin and CO2 levels are too low."

"Which we would expect with renal failure," House added. House still didn't have enough information to make any definitive diagnosis; the fellows started listing off more possibilities. Finally House said, "Give the patient more fluids to try to flush his system and get a CT of his heart."

Susan finished putting the rest of the chemistry and immunology specimens from the proficiency tests on the analyzer and started working on the hematology specimens. Her instrument for the hematology specimens would only analyze a three-part differential and the test required a five-part differential. This meant that she was going to have to prepare smears and do the counts manually under the microscope. It had been quite a while since she had to do that and she hoped she still recognized all the different cell types. She started preparing her slides when Dr. House walked in, "Heard you had a run in with the patient." He said.

"I'm fine," she replied.

"Let me see." He said.

"Really, I'm fine. I'm a little sore and I expect to have a few bruises in the morning but I'm fine." Susan insisted

"What about the injection site?" House continued.

"That is also sore, but the needle was clean, so I'm not worried about it." Susan insisted.

"Do you have any numbness in your leg?" House asked.

"No," Susan said. "I really need to finish these results so I can submit them to the proficiency testing website before tomorrow afternoon. Seriously, don't worry about it." House nodded and decided to leave her alone for now.

Four hours later Susan was finished testing all the proficiency specimens. She looked over all the reports and everything looked good. There were no instrumental errors, process errors or any specimen quality interferences. She really hoped the specimens sitting so long didn't impact the results, but there wasn't any way to control that. It was late and she decided to call it a day. She would input the results tomorrow. It would take her a couple of hours, but she had plenty of time to get it done. She had a headache from staring in the microscope so long, her fingers were stiff from using the manual cytometer and the places Andy had hit her were really sore. Her leg was tender and was getting stiff from sitting in the lab chair for so long. She shut everything down and headed up to tell Dr. Wilson she was headed out for the day and as she started to leave she remembered she had picked up Dr. House on the way into work. That was so long ago and so much had happened, it almost seemed like a different day. She poked her head in his office, "Do you need a ride home?" she asked. Dr. House shook his head no and Susan left.

At home Susan warmed up some leftover meat loaf and turned on the television. It was Monday. Her favorite show was on tonight and she hated missing an episode of this one. The lead actor was a British comedy actor that had come to the US to star in a television drama; he was an awesome actor and incredibly good looking on top of that. She didn't have a lot of time to spoil herself, but she allowed herself this one obsession in life. After her day today, she really needed the distraction. When the show was over, Susan cleaned up dinner and got ready for bed. She rubbed her arm and her side – they were really sore. She was sure there would be bruises the next morning. Andy, although mentally retarded, was a grown man, large and very strong. He probably didn't realize his own strength. She wondered what was going to happen to him later. His mother was well into her 70's and soon wouldn't be able to take care of him. Susan hoped that there was other family available for Andy when his mother got to the point she couldn't care for him any longer.

The next morning, Susan was awake before her alarm went off. She started to get out of bed and stopped short. "Oh, wow" she said to herself. She was really sore this morning. She stumbled out of bed and headed to the bathroom. After the morning necessities were complete, she stripped down for her shower. Looking at herself in the mirror over the sink, she saw a huge bruise on her left side. There was a bruise on her arm as well, but it wasn't as dark. She turned around and tried to look at the back of her thigh, but she was too short to see that far down in the mirror. It was sore, but she was sure it was fine. After her shower, she began to dress. As she pulled up her jeans over her thighs she gasped with pain from the pressure on the back of her thigh. "I guess I'm not wearing jeans today," she told herself. She went into the closet and pulled out a pair of scrubs. She hated scrubs, especially when it was cold outside. They were just too thin and when she bent over to take people's blood, they were able to see down her top. She was too modest for that, so she put on a color coordinating mock turtle neck to wear under her scrub top and slipped on a pair of short spandex shorts to wear under the pants to make her feel a little more covered. She just didn't like the loose feel of scrubs. Normally when it was this cold and she had to wear scrubs she would wear long underwear under her scrub pants, but she thought that if her jeans were tight enough to put too much pressure on the back of her thigh, then the long underwear would too. It's not like she wore tight clothing. At her age and even though she wasn't overweight, she had a motherly body shape and she chose to spare the world that particular view.

When she arrived at the hospital, she took the elevator up to Dr. Wilson's office. "Good Morning," she said as she poked her head inside. Dr. Wilson was on the phone. He waved her into his office and gestured for her to sit down. When he got off the phone he asked her what her plans were for the day.

"I finished running the chemistry and hematology PT (proficiency testing) specimens yesterday. I need to submit them for evaluation this morning."

"When are they due?" He asked.

"By 5:00pm today," she responded.

"That's cutting it pretty close," he said.

"Yes, it is. I don't normally operate that way, but there wasn't much of an option in this case. Dr. House insisted that I run the tests and so the specimens have sat in the refrigerator waiting for my return for more than a week." Susan explained. Wilson nodded his acknowledgement and dismissed Susan to start her day. As Susan made her way to the lab, she realized that her leg was really starting to hurt. She thought that the bruise back there must be pretty good size and deep. She entered the lab and put her thoughts aside. It was time to start her daily maintenance and QC (Quality Control) routine and then she would sit down and submit her PT results. Before she was able to sit down at the computer, she was called up for differential conference. She put her stuff away, washed her hands and headed up to the conference room. Dr. Taub noted the scrubs she was wearing and asked what was up. Susan shrugged her shoulders like it wasn't anything out of the ordinary. Dr. House looked at her thoughtfully.

Dr. House started the differential by asked for the results from yesterday's CT exam. "The patient is borderline cardiomegaly and has pulmonary arterial hypertension, but there are no nodules or consolidations." Chase offered.

"The patient had several more episodes of drenching sweats and rigors during the night, so we ordered a couple more STAT labs drawn and it appears that the acute renal failure is resolving itself." Foreman added. Foreman looked at Susan, "We didn't want to disturb you last night so we figured if we ordered the labs as STATs we could get the main lab to run them without too much complaint," Foreman explained. Susan nodded appreciatively.

"So, with the extra fluids he's getting, it's countering the affect of the profound sweating," House said. He paused for a moment and then said, "Start the patient on Topiramate and get an MRI of his head."

"Topiramate? Are you thinking Shapiro's Syndrome?" asked Taub.

House nodded and said, "The MRI will confirm the diagnosis if the patient has agenesis of the corpus callosum." The fellows got up to follow House's orders and Susan sat there for a moment. "What's up?" House asked.

"Nothing, I'm just moving a little slower today." Susan responded as she got up to go to the lab. As she left, Dr. House noticed she was favoring her right leg.

Susan was sitting at the computer submitting the last of her chemistry results. She still needed to submit the hematology results and then Dr. House poked his head in the lab, "Clinic" he said. Susan looked at her watch; it was 12:30pm. She hadn't had lunch yet, but she didn't feel much like eating anyway. Clinic generally lasted four hours; she would still have time to get the results submitted for the hematology specimens when she was done.

At 4:00 – a half hour early, Dr. House had seen his last patient. Susan was glad to have the extra time and started gathering the specimens from clinic duty. She started to head out of the exam room when Dr. House stopped her, "Drop them." he said. Susan sat the specimens back down. "I mean your pants," he said.

"I beg your pardon?" Susan asked.

"Take off your scrub pants," House said. Susan just looked at him. "You look feverish and you're favoring your right leg. I want to see where the needle penetrated your thigh. I know you wear shorts under your scrub pants, so I won't even see your underwear much less anything else."

Susan was hesitant but she complied. As she lowered her scrub pants and laid face down on the exam table she wondered how he knew she wore shorts under her scrub pants but decided not to pursue the matter. Dr. House examined the wound. There was a severe contusion and it was hot to the touch indicating a developing infection. "You're sure you didn't inject the needle into the patient before he knocked you over."

"Yes," Susan replied. "The needle should have been sterile."

Dr. House called Chase, "Check the patient's left arm for any unexplained needle sticks and call me back."

"I'm not lying, Greg," Susan said. She felt OK calling him Greg when they were alone and he never corrected her for it.

"I'm not saying you did; I just want to make sure that he didn't accidently hit the needle with his arm without you knowing it." He explained. Dr. House continued examining the injection site then using a syringe pulled a sample from the wound. It was definitely infected with something. He cleaned the area and covered it with a bandage and told her to pull her pants back up. Before she could tuck her undershirt back into her pants, Dr. House had lifted her shirt to look at the bruise on her left side. He lightly pressed on it and was rewarded with gasp from Susan. "Well, it appears that your side is just a severe bruise. I don't see any indication of any broken ribs, but you've developed an infection in your thigh." Chase called back to confirm that there were no injection sites on the patients arm. "OK, no needle penetration on the patient's arm, but the needle must have picked up some bacteria from the floor when it dropped." He said. Handing her the syringe with the sample in it he said, "Analyze your specimen and see what kind of bacteria it is, in the meantime I'm going to write you a script for a broad spectrum antibiotic that I want you to start taking right away." He handed her the script which she took along with all the specimens of the day and walked out of the exam room.

Susan looked at her watch; it was 4:40pm. "Crap!" she said to herself. She had 20 minutes to get the hematology PT results submitted. She ran to the lab as quickly as she could with her leg hurting like it was. She put everything down and sat down at the computer. She didn't notice that she had dropped the script on her way to the lab.

"That was close," she thought to herself, "two minutes to spare," as she hit the submit button with relief. Susan went over to the specimens from clinic duty and prepared the blood specimens for overnight storage. These were clinic patients and none of them were designated as STAT specimens. If she had her own evening lab tech, she would have him or her run the specimens, but it was OK, they could wait until tomorrow morning. The microbiology's were different however, so she took the time to plate them all, including her own, and put them in the in the incubator to grow overnight. It was past time to leave. She looked around for the script, but didn't see it. She must have dropped it on the way to the lab. She decided she would just go see Dr. House and get a new one. She went by his office; he'd already left for the day. She tried to call him, but he didn't answer his phone. She went to Dr. Wilson's office and he had already left for the day as well. "I guess it'll wait until tomorrow." She thought to herself and then she left for home.

House and Cuddy lay quietly together in post coital bliss with Cuddy's head resting comfortably on House's shoulder as he softly stroked her back. Finally Cuddy broke the silence, "I heard through the hospital grapevine that Susan got hit by a patient yesterday."

"Yep, he nailed her pretty hard. She has a big bruise on her side, but I didn't see any indication of broken bones. I am a little concerned about the injection site however." House said.

Cuddy lifted herself up on her elbow, "Injection site?" she asked.

"When she fell, she landed on the needle she was getting ready to use to draw his blood. It penetrated the back of her thigh pretty deep and now she's developed an infection." House said.

"House, all injection accidents are supposed to be reported to the safety department." Cuddy admonished

"Relax. It'll be fine. She didn't stick the patient with the needle before the accident; it probably just picked up some bacteria from the floor. I've given her a script for a broad spectrum antibiotic and told her to analyze the sample I took from the site for the bacteria type." House said.

"Regardless, I want you to fill out an incident report and submit it to the safety department first thing tomorrow." Cuddy insisted.

"Yes Ma'am," House replied. Cuddy smiled at him and lay back on his shoulder. House kissed her forehead and settled in for the night.


	5. Chapter 5

Chapter Five:

The next morning Susan felt weak and tired and her leg really hurt. She decided that she would go visit Dr. House first thing when she got to the hospital. She limped to the bathroom for morning necessities, showered, changed into another set of scrubs and headed off to work. She dropped by Dr. Wilson's office, but he was in a meeting. As was becoming a regular occurrence, Dr. House was nowhere to be found when she needed him. She went down to the lab to start her morning routine of maintenance and QC and started working on the microbiology specimens until she was able to meet up with Dr. House. "Patient's come first," she told herself and worked up those specimens before she started on her own. The three clinical cultures showed that these patients all had UTI infections. Luckily all of them were susceptible to both Bactrim and Cipro. She finalized the reports and sent them electronically over to Nurse Jeffery and Dr. House. Dr. House would order the antibiotics and Nurse Jeffrey would contact the patients and get them back in to pick up their prescriptions. Finally she pulled out her specimen, nothing was growing yet. "Hmm, she thought – that's not a good sign." She knew she had an infection that much was obvious – but some of the more aggressive varieties take 48 hours to culture. She put her specimen back into the incubator.

The phone rang. It was time for differential so she slowly made her way up to the conference room. Sitting at the foot of the table, Chase began the differential by confirming that the MRI of the patient's head had confirmed agenesis of the corpus callosum. The patient had Shapiro's Syndrome. The renal failure had occurred as a result of fluid loss during the frequent sweating episodes. Dr. House told the team to continue the treatment with Topiramate and as soon as the patient was stable enough to leave, to release him. He would continue on Topiramate indefinitely and one of the fellows would follow up with him in a month to see how he was doing. Dr. House left the conference room and went to his office and the fellows got up to leave. Susan was so tired. She stayed sitting where she was and put her head down on the table, just for a moment. It wasn't long before she felt somebody's hand on her shoulder. Dr. House was standing beside her.

"You fell asleep," he said. She looked up at him to apologize and when he saw her flushed face, he felt her head. "You're burning up." He said.

Susan said, "I need you to write another script for that antibiotic; I lost the one you gave me yesterday."

"Damn," Dr. House said. "I wanted you to start that antibiotic right away."

"I must have dropped it on the way to the lab, I tried to find you to get another one, but you had already left and didn't answer your phone. I decided that one more night wasn't that big of a deal." Susan explained.

"Well, obviously it was a big deal and you should have tried harder to contact me. You can always call Dr. Cuddy's phone if you can't get me on mine. Is anything growing on the culture yet?" he asked.

"No" Susan replied. This meant that it was probably a staph, the question was – which one? Dr. House decided it was probably MRSA given how and where she had obtained the infection and decided to put her on IV antibiotics instead. Normally a healthy person could fight off staph infections pretty easily, but this one had started from a traumatic injury and the bacteria had taken advantage of the weakened tissue. She obviously couldn't keep working in her current condition, so avoiding the rules as he was inclined to do, Dr. House found a room and hooked up IV antibiotics to fight the infection without actually admitting her.

A few hours later Dr. House dropped by her room to see how she was doing. She wasn't in bed. He stood there for a moment and then realized where she probably was; this 'patient's come first' attitude of hers at least made her predictable. He grabbed a thermometer and a blood pressure cuff and left the room. Sure enough, he found her working in the lab. She had walked down to the lab, IV pole and all. Her hand was wrapped and gloved over her IV injection site. She was working on the clinic specimens from the previous day. He walked over to her, "What are you doing up?" He asked. "Patients come first," she said. "Besides, you didn't admit me to the hospital, so I was just taking up bed space. I can either sit in bed and get IV antibiotics or I can work down here and get IV antibiotics. Either way, I'm getting the antibiotics and at least this way I'm more productive. I'm being careful." She said as she held up her IV hand for him to see.

Dr. House didn't say anything, but took out the thermometer from his pocket and took her temperature. She was still feverish, but her temperature had dropped a little. Her blood pressure was fine. He listened to her heart and lungs and all was well so he decided to let her keep working. It wasn't following the rules, but when had he ever followed the rules? "I want you to stay here overnight so we can keep running IV antibiotics through you. When you get finished, since I know you're going to keep working until you are done anyway, go back to your room and get some rest." House said.

"I will," Susan replied.

True to her word Susan went back to her room when she finished testing the specimens. Her culture still hadn't grown anything yet, but she figured by tomorrow morning the bacteria colony would be big enough to analyze. At 5:00 Dr. Chase came into her room.

"Dr. House said you would be in here and asked me to check on you. How are you feeling?" he asked.

"Better," replied Susan. "I imagine by tomorrow I'll be back to my normal self."

Dr. Chase checked her vitals and said, "Your temperature is almost back to normal. I guess we caught this thing early enough and these antibiotics are pretty strong. That's a good thing, with MRSA it can go bad very quickly."

"Well, we still don't know if this is MRSA, it may just be a simple staph infection," Susan replied. "We'll know tomorrow for sure, but I don't plan on being stuck in this room tomorrow."

Dr. Chase left her to rest and Susan turned on the television. She flipped channels before she decided that nothing was on tonight that she was interested in, so she turned off the TV, got up and left the room. She found herself walking by Andy's room. His mother was asleep on the chair next to the bed while Andy had the TV turned to SpongeBob Square Pants. He was laughing at Patrick's antics when she walked in. "How are you feeling Andy?" Susan asked.

"OK," he said. He looked around the room to see if anybody was listening and whispered, "My pee pee is working again."

"That's great Andy," Susan said. Andy looked over and stared at his mother. Finally he said, "She's getting old."

"Yes, she is. Everybody gets old Andy," Susan told him.

"I know," he said. "My dad got old too." Andy got a sad look on his face, "And then he died and went to heaven." He continued. "Do you think Mommy is going to die too?" he asked.

"Everybody dies Andy," said Susan. He obviously knew what death was, so there wasn't any point in lying to him.

"Who is going to take care of me when Mommy dies?" he asked.

"Do you have any brothers or sisters?" Susan asked. Andy replied that he didn't. Mentally, Susan guessed that Andy was around 8-9 years old. Old enough to comprehend death, but certainly not old enough to take care of himself and it was apparent that he was afraid of what would happen to him. "Have you asked your mother about it?" Susan asked.

"She said not to worry about it," he said. "Well then, she probably has everything figured out already so try not to worry," Susan said.

Andy was quiet while he watched the TV and then he said, "I'm sorry I hit you." Susan patted him on the arm and told him that it was OK; she knew he didn't mean to hurt her. Susan told Andy that she was going to go back to her room and to sleep well. Andy told her goodnight and Susan got up to leave. She made a mental note to tell Mrs. Purdue of Andy's concerns the next morning.

Andy was responding well to the Topirimate and was set to be released at 1:00pm. Susan wanted to get down to his room in the morning before the rush of activity that occurred just before Andy's release. She walked in the room, still dragging her IV pole and sat down next to Mrs. Purdue. Andy saw her and said, "Hi Susan."

"Good morning Andy," Susan replied.

Mrs. Purdue asked, "Is there something you wanted to say?" Susan told her about the night before and Andy's concerns. Mrs. Purdue smiled, "Yes, we have that all arranged. After Andy gets released from the hospital, we are moving into an assisted living center. I don't really need the help for myself, but Andy is getting harder for me to manage all alone. When I get to the point that I can't take care of him anymore, we'll move him into the nursing home side of the center where he will continue to live out the rest of his life. I haven't explained all that to him because it's so difficult for him to understand things." She continued.

"Well, he seems to have a pretty good grasp on death and he is definitely concerned," Susan said. Mrs. Purdue said that when they got out of the hospital she would discuss it with him. Susan got up and went back to her room. Dr. House was waiting on her when she walked in.

"What do I have to do to keep you in bed, tie you down?" he asked. Susan just grinned at him, "Sit down," he ordered. He took her vitals and declared her cured enough to work as if he could keep her from it anyway. She wasn't contagious, but as a precaution he wouldn't have her work in the clinic with him for a few days, so she would stay fairly isolated in the lab. He removed the IV and pulled a bottle of antibiotics out of his pocket. "I decided to fill these for you so that you wouldn't lose the script again. Take them until you've taken all of them – oh and fill out this paperwork," he said as he gestured to a folder on the bedside table, "It seems that when you have a needle stick injury you're supposed to report it to the safety department." He said and then he walked out the door.

Susan found a pair of hospital scrubs to change into and used the doctor's locker room to shower before she went to the lab. She didn't have any specimens waiting on her, except her own. She started analyzing it just for something to do since she was obviously OK. It was MRSA – House was right, again. Well, they'd gotten lucky and given the terrible side effects of that bacterial infection, she counted her blessings. Susan decided to give the news to Dr. House personally and went up to his office and sat down in front of his desk. While they were discussing her infection, Dr. Wilson came into the office. "Here you are. You haven't checked in with me for a couple of days."

"It's been rather busy and I did try, we just didn't cross paths." Susan explained.

"Come to my office," Wilson replied, "and we'll work out a regular schedule to meet."

Dr. House interjected as they were leaving, "She's still my employee, don't be giving her so much to do that will take her away from my team."

Wilson nodded and Susan said, "I don't feel like I did much to help the team with this patient."

"There will be other patients." He replied.

Susan and Dr. Wilson went to his office and sat down. Susan told him about the last two days. "Have you filled out the incident report yet?" He asked.

"The paperwork is sitting on my desk," she replied.

"You need to get that filled out right away and bring it here for me to sign it and you'll have to get tested for blood borne pathogens as well." Dr. Wilson said. "We also need to have the patient tested and you can't do this one, it has to be done by an independent lab for legality reasons."

"But why do I have to be tested, I hadn't stuck him with the needle before I fell on it?"

"Doesn't matter, hospital policy," Wilson replied. Wilson produced more paperwork for her to go to an independent lab to have blood drawn for the required tests. As they were filling out the paperwork, House opened the door.

"Gotta case – let's go," he said. Wilson nodded and Susan got up to follow House. They walked in the conference room and nobody was there.

"Where are the fellows?" Susan asked.

"I don't know," Dr. House replied.

"So, what's the case?" Susan asked.

"There isn't one," he said.

"So, why did you say there was?" Susan inquired.

House deflected, "Go back to the lab, you've got work to do." As Susan started down to the lab she wasn't sure if she really enjoyed being the football between House and Wilson's game of catch. She decided to go talk to Dr. Cuddy.


	6. Chapter 6

Chapter Six:

Susan knocked on Dr. Cuddy's door. Dr. Cuddy looked up and smiled, "Hello Susan, how are you feeling?"

"I'm fine, thank you. Do you have a minute?" Susan asked.

"Sure; have a seat. What can I do for you?" Dr. Cuddy answered as she gestured to the chair in front of her desk.

"I feel like a fire hydrant between two male dogs." Susan said.

"Interesting metaphor," said Dr. Cuddy. "I assume you're talking about Drs. House and Wilson."

"Yes. I understand that Dr. Wilson is responsible for my reviews and such, but I work on Dr. House's team which means that I really work for Dr. House. Every time Dr. Wilson comes into the picture, Dr. House gets avaricious with my time." Susan explained.

"Well House does tend to be a bit possessive." Dr. Cuddy said. "Let me talk to him and we'll see what we can come up with."

"OK, thanks," Susan said as she got up to leave. Just before she walked out the door Cuddy stopped her.

"Susan, just so you know, because I know he rarely says anything, Dr. House is really glad to have you both on his team and in his life." Cuddy said.

"He isn't big on platitudes, but I had picked up on that a little. I appreciate you telling me though; it's nice to have the confirmation. He really is a lot like my dad, which is amazing really. I guess not everything about your personality is related to your environment." Susan said.

Cuddy had one more question for Susan, "When you first came to the hospital, you said that when you saw him, you realized who he was right away. Does he look a lot like your father?"

Susan smiled, "He resembles his mother mostly, but he does have my father's height, blue eyes and he has the same square jaw. He's also very thin as my father was. What I recognized mostly was what I had seen when I was young. Although he's obviously aged, he has retained a lot of his look from when he was a kid. I wish I had known who he was then, it would have been so cool to know I had an older brother then. But then, I guess that would have caused a lot of problems for his mom."

Susan left Dr. Cuddy's office. Dr. Cuddy decided to invite Susan over for dinner this weekend so the two siblings could get to know each other a little better. She had noticed that outside of the differential conferences, Susan spent most of her time alone and she didn't want her to feel isolated.

When Susan returned to the lab, there was a box sitting on the lab table. It was another proficiency test. House wasn't _just_ trying to get her out of Wilson's office; she really did have work to do. She opened the box and this set of tests was for microbiological specimens. "Well, at least I have more than one day to get them done," she thought to herself. There wasn't any reason to delay, so she got started. There were five vials of unknown microbiological specimens. She started by plating them on blood plates. It was highly likely that each specimen vial had multiple agents. Susan expected to have to plate each one several times to isolate individual bacteria colonies. This is going to be a several day process. Susan hated proficiency exams, the chemistry and hematology exams were pretty easy – but identifying unknowns always made her stomach flutter. In reality is wasn't any different that identifying what was ailing a patient, but it still bothered her more than the standard specimen. She supposed the part that bothered her more was that in most labs, proficiency tests were spread around everybody. Each specialty group in the hospital lab had their own set and people in each department were checking each other to verify, but in her lab – she was it. She had to do everything, the pressure was huge. It was enough to make her stomach hurt. Finally she finished plating the specimens and was working on her regulatory paperwork when she heard the distinctive step-tap-step-tap that was Dr. House. She looked up as he walked in the lab and smiled. "What brings you to my world?" she asked.

Dr. House sat on the lab stool and said, "I figured it was my turn to piss on the fire hydrant," he said.

Susan grinned, "You've been talking to Dr. Cuddy." She said.

"So now is it my turn to say something obvious." He said. "Except that I don't have anything obvious to say. Cuddy would like you to join us for dinner tomorrow evening."

"You say that as if you don't." Susan responded.

"I'm fine with you coming for dinner, just don't stay too long." He replied.

Susan started, "I'm not here to interfere….." then she saw his face and realized he was harassing her. She smiled, "What time?

"Be there at 7:00." He said. Dr. House got up from the chair and walked out of the lab. Susan finished up her paperwork and decided to call it a day. She texted Dr. Wilson to tell him she was headed out.

Later that night the phone rang. "Hello," Susan said.

"Mom," said the voice on the other end.

"Hello sweetheart, how are you doing?" Susan asked.

"I'm fine, I was thinking about coming home this weekend," Laura said.

Susan thought it was interesting that Laura referred to this place as home. It's not where she grew up. She guessed that _home_ was wherever _Mom_ was. "I look forward to seeing you. What time will you be arriving?" Susan asked.

"I'm leaving as soon as I finish my last class, which should probably get me there around six," Laura replied.

Susan wondered if it would be OK to ask if Laura could join her with House and Cuddy for dinner or if she needed to decline the invitation. "OK, if I'm not home yet, you have a key. Oh, by the way, I had the piano tuned last week so it's all ready to go for you." Susan said.

"Great, I'll see you tomorrow," was the reply. Susan's piano was an old spinet that her mother had given to her when Laura was just a toddler. It was not a high dollar piano, but it had done the job. The man that tuned the piano was impressed with it telling her that for a spinet, it had a really nice full tone. Susan really missed listening to her daughter play. Over the years she had really become quite accomplished winning contests and eventually was able to get a small piano scholarship with the understanding that she would at least minor in music, which she was doing. The scholarship wasn't much, but every little bit helped. Susan was trying to get her through her undergraduate school without ending in debt from student loans. As a result, most of her salary went toward her daughter's education. She lived as meagerly as possible in order to make ends meet.


	7. Chapter 7

Chapter Seven

The next morning as Susan entered the hospital, she veered over to Dr. Cuddy's office. Dr. Cuddy was in a meeting, so she left message with her assistant asking her to call the lab when she had opportunity. Susan went to Dr. Wilson's office for her morning meeting – he wasn't at his desk. "He must be tied up with one of his patients," she thought. She stole a post-it note off of his desk and left a note, then headed to the lab.

As usual, the lab was quiet – well as quiet as a lab can be with all the instruments running. She ran her daily maintenance, QC and documented everything. She went over to the incubator and pulled out the first plate from the PT specimens and took it over to the bio-hood. It had three separate colonies growing on it. She isolated the colonies onto the new plates, labeled the plates A1, A2 and A3 and then put them and the original 'A' plate into the incubator for another 24 hours. Maybe she should have started these on Monday instead of yesterday, she thought to herself. At this point, she was going to have to come in over the weekend to work up the specimens. While she enjoyed the solitude in the laboratory, there were times it would be really nice to have some help. It's too bad that Dr. House was such a misanthrope, or she might've been able to talk one of the main lab techs into helping her from time to time. The second specimen plate only had one colony in it. She isolated it onto another plate and labeled it B-1. Following the same routine with the rest of the specimens, she finally finished isolating all the colonies. Just as she was putting the last plate in the incubator, Dr. Cuddy called the lab, "Susan, I have a note that you needed me to call you."

"Yes," Susan replied. "I'm afraid I'm going to have to decline your invitation tonight, my daughter called from school and she is coming home for the weekend."

"Oh, you don't need to decline, just bring her along." Cuddy responded.

"You're sure?" Susan asked.

"Absolutely," Cuddy replied.

"Great then, we'll see you at 7:00."

The rest of the day was uneventful, so Susan spent her time catching up on paperwork and read a couple of _Lab Medicine_ journal articles. It was 4:00 and she wanted to go home, she had a couple of things she wanted to do before going over to Dr. Cuddy's house. She texted Dr. House for permission to leave; he didn't respond, so she walked to his office and he wasn't there. She went around the corner to Dr. Wilson's office, where she found both of them. "I'd like to head out early if I could; my daughter is coming home for the weekend and ….."

"Scram." House interrupted.

Susan left. On her way home, she stopped by the grocery store to pick up a few items. She had been raised that when you are invited to someone's home for dinner, you always brought something along. After she paid for her items, she made her way home. Outside the door of her apartment, she heard the piano. Laura was home. She listened for a moment or two enjoying the sounds emanating from inside before she opened the door. "Hey sweetheart, you got here earlier than you thought you would," she said as she walked over to Laura and gave her a hug.

"We had an exam in my last class and I finished early," she said.

"We're going to Dr. Cuddy's house for dinner tonight," Susan informed Laura.

"OK, so what are we bringing?" Laura asked.

"I thought I would make an apple pie to take," Susan replied. Laura nodded her head in approval; everybody loved her mom's apple pies. Laura turned back to the piano to continue working on her piece. This was the piece she was playing for the freshman recital and she still hadn't finished working through the last four lines. After she finished working through them, she would fine tune and perfect and of course she had to play it memorized for the recital. She still had a few weeks before the recital, if she practiced every spare minute she had then she would have it ready in time.

Susan finished putting the pie together and put it in the oven. It should finish baking by 6:30 and then they would head over to Dr. Cuddy's. They would be around 5 minutes late, which Susan thought was about right.

The door bell rang and House limped over to answer the door. Standing in the doorway was Susan and her daughter. House hadn't seen Laura very often, but every time he did, it always amazed him how much taller she was than her mother. His attention quickly shifted to the pie in Susan's hands. His mouth was already watering in anticipation, "That's mine," he said taking it from her. He limped over to the kitchen and set it on the cabinet. He started lifting the aluminum foil off of it to sneak a piece when Cuddy slapped his hand.

"After dinner," she said. Properly admonished, House went back into the living room and sat down to watch television. "You didn't have to bring anything," Cuddy said.

"It's my family tradition," Susan replied. "Anytime we are invited for dinner, we bring something."

"Well, it smells fabulous. I look forward to trying some,"

"No you won't!" came the voice from the living room, "It's mine!"

Susan smiled and asked if there was anything she could do to help. Laura had walked in behind her mother and put a carton of vanilla ice cream in the freezer to go with the pie and then went into the living room. Seeing Rachel on the floor playing with a wooden puzzle, she sat down next to her and helped her put the pieces in the right places while the two mothers made final preparations for dinner.

Dinner was great. Susan knew that Dr. Cuddy was a vegetarian and she had prepared vegetarian lasagna for dinner. Susan had actually never eaten vegetarian lasagna and it was much better than she had expected. Even Laura had enjoyed it, and she abhorred vegetables. She decided to wait until they got home to tell Laura that she had just eaten spinach and eggplant.

After House had eaten two helpings of lasagna, he looked at Cuddy and said, "Mom, I finished my plate can I have pie now?" Without waiting for an answer, he got up and fixed himself a piece of pie and completely covered it with vanilla ice cream.

Dr. Cuddy just looked at him, "Aren't you going to offer to get some for anybody else?"

"Nope, I told you it's mine," he answered as he sat back down at the table.

"Actually I'm quite full and Laura doesn't like pie, and it was my intention to leave the dish here." Redirecting her gaze to House, she continued, "However, I did expect you to share with your family,"

"I told you before, we're not a family," House responded.

"Close enough in my book," said Susan.

Switching the subject, Cuddy asked Laura, "What are you studying in school?"

Laura explained that her intention was to go to medical school, so she was studying microbiology and adding the other necessary courses so she would qualify for admittance. But, since she had a music scholarship, she was getting a minor in music as well. The classes weren't nearly as hard for her, but the performance portion took up a great deal of time with all the practicing. It was hard to balance her homework and studying for her science classes and practicing for her music classes. "I have to perform at the Freshman Recital in just a few weeks, and I haven't perfected and memorized the piece yet." Lauren added. "I decided to come home this weekend so that I could spend a lot of time practicing. It's hard to get access to the pianos at school, you have to reserve them in advance and you're only allowed to reserve two hours at a time. Our piano at home doesn't work as well as I would like for the piece I'm playing, but at least I get more time on it."

"What's wrong with our piano Laura?" Susan asked.

"Nothing," she replied, "but this is a Chopin piece and my hands are too small to hit all the notes without moving to the top of the keys. The keys on our spinet are shorter than they are on larger pianos, so I end up having to leave some notes out of the cords."

House took his last bite of pie and ice cream and fished his hand down into his pocket. "I'm staying here all weekend, you can practice on my piano as much as you like," he said as he tossed her his apartment key.

Laura was stunned, "You barely know me and you're allowing me access to your apartment without you being there?" House just nodded and then got up from the table and went back to watch television.

Later as Susan and Laura were driving back to Susan's apartment Laura asked, "What kind of piano does Dr. House have?"

"I really don't know. I haven't been to his apartment, but I'm guessing it must be a studio or baby grand. A grand would be too big for an apartment in his neighborhood and if it was a spinet, he wouldn't have bothered letting you use it because it would have the same problem. I wish I could afford to buy you a bigger piano sweetheart," Susan said.

"Don't worry about it mom, our piano has a great sound and for the most part I don't have any issues, but Chopin pieces and my small hands push the limits of what I can do on our piano."

Saturday morning after Laura had left for House's apartment to practice, Susan went to the hospital to check her PT specimens. There were no additional colonies on the original specimen plates and the sub-plates were growing well. The colonies on the sub-plates were all big enough to allow identification. She prepared the specimens and put them on the Walk-Away for identification. Fortunately, for the purposes of the PT exam, only identification was necessary. She didn't need to perform susceptibility testing which would speed things up a bit. As she gathered her things to go back home, she thought about how much more time it would take for identification of the bacteria if things weren't automated. She would have had to prepare slides and do a gram stain on them, then identify them by bacterial type and then sub-type them. That process was a lot longer and there was no way she would be going back home so soon if she had to analyze them the old fashioned way.

Back at her place, Susan did her normal Saturday housecleaning chores. She turned on her stereo and listened to some blues music while she dusted and vacuumed. Her doorbell rang. She turned down the stereo and went to the door. As she looked out the peephole in the door, she was startled to see a giant blue eye staring back at her. She opened the door and found House standing outside the door holding Rachel's hand with his left and his cane and her pie dish in his right. "Cuddy got called in to the hospital…." he started as he handed her the pie dish.

"And you got stuck babysitting," Susan finished for him.

"Something like that," he said. "I decided to bring her over here," he added.

"You're still not comfortable being alone with her," Susan stated.

"Something like that," he said again.

"Come on in," Susan said. "I don't have any toddler toys anymore, does she like to color or does she still eat the crayons?" Susan asked

"This kid eats everything, even money," he said. House brought Rachel inside and he sat down on the sofa. Rachel climbed up next to him and sat down.

"Well, you may not be comfortable with her, but she's certainly comfortable with you," Susan said handing him the remote. "I don't have cable, but I think there may be some cartoons or something on network television," Susan said

"Why don't you have cable?" House asked as he turned on the TV and started flipping channels.

"It's expensive and for the most part nothing is on. I don't watch that much television anyway." Susan said.

There weren't any cartoons on, but PBS was showing an old episode of "Sesame Street" so he kept it there.

Susan got up and went to the kitchen, "Can I get you something to drink?" she asked.

"Bourbon would be nice," he replied

"I don't drink Greg; I don't have any alcohol. I have diet sodas and some Dr. Pepper or I can make you some iced tea if you like."

"Dr. Pepper would be fine," he replied. House sat for a moment watching the television. He would never admit it, but he actually didn't mind Sesame Street – he thought that Oscar the Grouch was pretty cool.

"Is Rachel allowed to have cookies?" Susan asked.

"Only if I get to have some too," he replied.

Susan smiled and brought him his drink and both of them a couple of cookies. She down in the chair next to the sofa, "I appreciate you letting Laura use your piano this weekend," she said. "Not a problem," he said. "How long has she played?" he asked.

"Since she was five, she wanted to quit when she was in 5th grade and we battled for a time about it, but I wouldn't let her quit. I knew that if she quit playing, she would regret it later. A couple of years later, she fell in love with it again and she's never had any inclination to stop since then. It's a blessing because she was able to get this scholarship and even though it only covers part of her tuition, every little bit helps" Susan said. "I need to finish cleaning the bathroom. I don't want to leave out the cleaning supplies with your rug rat here, are you comfortable?" House nodded and Susan left the room to finish the last of her chores.

While Susan was out of the room and Rachel was quietly watching Sesame Street, House used the opportunity to snoop around. The apartment was simply decorated. Most of the furniture was old, but in fairly good condition. There was an antique bookcase and secretary with chair that House assumed she had gotten when her parents died. The piano was sitting next to the only other wall space in the room opposite the bookcase. He browsed the titles on the bookcase; mostly they were text books she had kept from her years in college and graduate school. There were a few novels by Tom Clancy and John Grisham. So she liked action and suspense, no romance novels he noted. On the second shelf were an old family Bible and several unmarked books. He pulled one down, it was a photo album. Most of the photos in the album were of Laura as a child, but he did find a couple images of Susan's late husband as well, usually busy doing something with Laura as if the photo was purposefully taken when his attention was elsewhere. Not surprisingly, he was tall, thin and had blue eyes like Susan's father – well, that explained Laura's height. House started to wonder why Susan was so short, he knew her dad was tall. He couldn't remember her mother at all, she must have been short and Laura must have gotten the 'short gene' from her. There were very few photos of Susan in the album, which meant that she was the one taking the photos and there were no family portraits which he thought was odd.

"Looking for anything in particular?" Susan asked. House swung around to look at her, "No, just looking," he replied. House put the album away and sat back down next to Rachel, "What happened to your husband?" he asked. Susan told him about the sudden heart attack he'd had not long after her father had passed away.

"It was quite unexpected as he had been completely healthy his entire life," she said with sadness in her voice. "I miss him," she said as tears started forming in her eyes. Susan held back and the tears never fell.

"I take it there wasn't much in the way of life insurance," House said. Susan looked at him inquisitively and he continued, "You live in a small apartment with meager furnishings and there is no savings for Laura's schooling."

"There was a small policy as part of the benefits from his job, but when the economy tanked the company I worked for claimed bankruptcy and went out of business. His salary wasn't enough to cover all our bills and we used up all our savings to survive while I tried to find work. Then dad got sick and I had to take care of him. I found a small research job just before my husband had his heart attack, but being research; it didn't pay much of anything. When my husband passed away, I had to use that insurance policy to pay the debts we had accrued while I was off work, so there wasn't any left for Laura's schooling. I sold our home for just over what we still owed on it and used the last of the money from that to move out here." Susan explained. "I don't have any debts left at this point, so I don't have to worry about making payments on anything. My salary covers my living expenses and I put the rest of it into Laura's education."

The door opened and Laura walked in carrying a plastic bag from the local department store. Noting the presence of Dr. House and little Rachel she said, "Hello Dr. House. Thank you so much for letting me use your piano; it has a beautiful sound."

House nodded and told her, "You don't have to call me Dr. House, "House" is fine, or "Uncle Greg" if you prefer."

Susan grinned at him, "_Uncle_ Greg? Seriously?"

"Well, if she calls me that, I'd prefer it not be when we're at the hospital or around my team," he added suddenly embarrassed.

Laura laughed and then asked Rachel if she wanted to go to her room. Grabbing Rachel by the hand, Laura led her to her bedroom where she shut the door

"What do you suppose that is all about?" House asked.

"I have no idea." Susan replied. "You hungry?" she asked.

"Always," he said. Susan got up and went to the kitchen to fix something to eat and House followed behind. Perusing through the freezer, Susan pulled out leftover ham she had baked over the previous weekend and made preparations for opened faced hot ham sandwiches complete with mashed potatoes and gravy. House's mouth started watering as he watched her prepare dinner. It wasn't often he got a home cooked meal with actual meat anymore and he found himself really looking forward to it.

"When is Cuddy coming home?" Susan asked.

"It'll be late, she has three meetings to attend and none of them promised to be short." He replied.

"On a Saturday?" Susan asked. House just shrugged, "I guess it was the only time their schedules coordinated."

When dinner was ready Susan called Laura and Rachel to the table. Much to House's surprise, Laura said grace before they started eating. "You pray?" he asked when Laura finished.

Susan said, "Sure, and we read the Bible too; why does that surprise you? You know how I was raised."

"I don't know, I guess I figured you would have grown out of that by now. I mean you're highly educated, you should know…" House started.

"That not everything can be explained," Susan interrupted.

"Just because we don't know the answers now, doesn't mean there aren't any," House said.

"And finding the answers to what we don't understand doesn't preclude the existence of God. Just because we know how He did it, doesn't make it any less His doing," Susan countered. "I understand that you are an atheist Greg, and I accept you as you are. I'm not a radical; I live my life according to the guidelines in the Bible and try to be a good example. I make plenty of mistakes. I lost my temper Monday; it's one of my weaknesses that I have to work on a lot." Susan paused for a moment, "I'm not here to try to change you or make you believe something that you don't, but I am here for you if you need me. You've told Dr. Cuddy that I had a good head on my shoulders and was an asset to your team; does your knowing what I believe today make me any less intelligent than I was yesterday?" Susan asked.

"No," said House.

"Then are we OK?" Susan asked. House nodded. After dinner Laura cleaned up dinner for her mother and then took Rachel back into her room while House and Susan relaxed in front of the TV. Susan realized that House wasn't much in the mood to talk, he just wanted the company and the reassurance that if something was to happen to Rachel he wouldn't have to deal with it by himself. After several moments of silence Susan's mind started wandering toward Dr. Cuddy. She wondered to herself how Cuddy and House got along with his atheism and her Jewish background. "Oh no," Susan said suddenly.

"What's wrong?" House asked.

"I am so sorry, it didn't even occur to me. We fed Rachel some of the ham for dinner," Susan said.

House smirked, "Don't worry, Cuddy's isn't kosher; she's just a vegetarian." It was getting close to Rachel's bedtime and House decided it was time to leave. Susan called Laura and when the girls emerged, Rachel was carrying three sheets of paper. She handed one up to Susan. It was a finger painting with grass, flowers and the sun. Susan gave Rachel a hug, told her thank you and then put it on display on her refrigerator.

"That looks perfect," she said to Rachel. Rachel beamed and then handed one of the others to House. It was a stick family of three with the sun overhead. He didn't say anything and looked down at Rachel who was staring up at him. He bent over to pick her up and carry her in his left arm and in a quiet voice said, "Let's go see mom" and they walked out the door.

"When did you get the finger paints?" Susan asked.

"I noticed House's car outside when I started to pull in and I wondered if he might have Rachel with him, so I detoured to the store and picked up some paints and a couple of puzzles just in case. I knew we didn't have anything around here to keep a 2 ½ year old occupied." Laura said.

"What was the other picture?" Susan asked Laura.

"It was another stick family for her mom."

"Did she do those all by herself?

"Pretty much, I mostly just helped keep the finger paint from getting all over everything."

"Well, House may not think they are a family, but Rachel does." Susan concluded.

"You think he's going to harass you about your faith?" Laura asked her mother.

"Probably," Susan said.

Sunday was quiet. After church and dinner, Laura left to go back to school. Susan shut the door behind her daughter and thought about her weekend. The results from her PT specimens should be ready, but the Walk-away was stable and there was no need for her to go in and do anything more with the specimens today. The results would be on the printout from the instrument when she got to work on Monday. She was apprehensive about going into work on Monday. She'd worked with Dr. House and his team for several months. She was sure the team wouldn't give her a hard time about her faith, but she was equally sure that Greg would. Well, it wasn't the first time she had to deal with that and it wouldn't be the last. That was the downside about being in science; you had to deal with people's ridicule all the time. "Oh well," she thought, "If it was easy, then it wouldn't be faith." Susan walked over to her piano. She wasn't anywhere near as accomplished as Laura, but she could play a little. She pulled out one of her books and began to play a simple arrangement of Amazing Grace. Finishing that, she started playing another old hymn when the doorbell rang. She saw it was Greg through the peep hole and opened the door. "Hi," she said "Please come in."

"We need to talk," he said.

"What's up?" Susan asked.

"Whose idea was it to draw 'family pictures'?" he asked.

"Laura said that Rachel did that by herself, she only helped keep the finger paint on the paper and off everything else," Susan explained, "Why?"

"When Rachel gave the picture to Cuddy last night, it made her cry and she wouldn't talk to me about it." He paused for a moment, "We're _not_ a family."

Susan motioned for House to sit down on the sofa. She sat down on the sofa facing him. "Why are you afraid of being a family?" she asked.

"I'm not afraid," he said. "My family life sucked and I just don't want that for them."

Susan pondered what he said. She remembered the colonel from when she was young. He was big and had a loud voice and she remembered being afraid of him. When her dad would take her there, she would race to wherever Mrs. House was and then run up to Greg's room. She remembered staying clear of the colonel as much as possible. He was never mean to her; she just was afraid. Always before she had attributed her fear to that of a little girl being around a domineering man, now she realized there was more to it that that. "He really did abuse you didn't he." She stated more than asked. House nodded without saying anything. "Dad said that he knew that John was a hard man, but he never saw any evidence of physical abuse when we came to visit."

"That's because dad's abuse, didn't leave bruises," House said. Susan realized that House was afraid of becoming his father.

"Greg, you are _not_ your dad. You're a little distant with Rachel, but you're not abusive in any way. It's obvious you are uncomfortable with her right now, but there is no way you would do anything to hurt her – and not only that, there is no way that Dr. Cuddy would allow it; she's too strong for that. The picture Rachel drew shows that as far as she is concerned, you are a family. _You_ are her dad." House stared off into the distance pondering what Susan said. "You just need to relax and let yourself become her dad. In time, the uncomfortable feeling you have with her will go away and you will grow to love her as if she were your own." Susan sat leaned back on the couch and sighed.

"What?" House asked. "When I first saw you at the door, I thought you were going to give me a hard time about my beliefs," Susan admitted. "I was apprehensive about your reaction and afraid it would adversely affect our relationship."

House was quiet for a moment, "No, it doesn't change anything; just don't bother trying to convert me. You'll never convince me is anything other than a mythology people have made up to make them feel better about themselves."

Susan decided not to say anything further. He knew what she was and what she believed and he was still OK with her. If he ever wanted to talk about it, she would be there for him, but she wasn't going to harass or hound him about it.

Later that night as Susan lay staring at the ceiling, she thought about the conversation she'd had with her brother. He was so afraid of creating a bad family atmosphere that he was on his way to creating a bad family atmosphere by trying to avoid it. Susan resolved to help him as much as she could, by being there for him as much as possible. She thought about her own family. How fortunate she was to have been raised in a good family. Though he would never appreciate it, she said a small prayer for Greg and then rolled over to go to sleep.


	8. Chapter 8

Chapter 8

Beep. Beep. Beep…..the alarm went off. It was Monday morning again. Susan awoke hoping that this week wouldn't be nearly as eventful as the last week had been. As she readied herself for work, she thought about the events of last week. Two sets of proficiency tests, an accidental stabbing, infection and IV antibiotics – all after just having gotten back from sick leave. It was enough to make Susan wish she had time for a vacation and she'd only been back to work for a week. Her phone rang. "Hello," she said. "Get in as quick as you can, we have a case" the voice said. Susan threw herself together and headed out the door wondering what was in store for this week.

Susan didn't bother going to the lab when she walked in the hospital. Dr. Foreman sounded as if this were an urgent case, so she went straight to differential. When she walked in the conference, nobody was there. She looked on the table and found her copy of the patient file and started looking through it. This was a 48 year old female that had been referred from another hospital. Over the last three months she'd had persistent fevers, fatigue and loss of appetite resulting in a loss of 20 pounds. The referring hospital had checked for infectious diseases and had performed a rheumatologic work up, both of which were negative. They'd performed a CT scan and noted heptosplenomegaly (simultaneously enlarged liver and spleen). She continued to degrade and was transferred to PPTH to Dr. House's team. Susan decided to drop her stuff at the lab and then try to find the team.

Susan found Dr. House standing outside the patient's room in ICU. The team was scurrying around trying to stabilize the patient from severe tachycardia. As soon as she appeared to be stabilizing, Dr. House turned to leave, "Come on," he said. Susan followed him to the conference room and sat down. The rest of the team filed in and took their spaces around the table.

Dr. House picked up his marker and started writing on the white board: fever, tachycardic, jaundice, distended abdomen, "What else?" he said.

Susan was looking at the CBC report from the other hospital, "low hemoglobin, low platelet count, mildly elevated ALT and AST, but a normal bilirubin level," she read. "This screams liver infection doesn't it?" she asked.

"Yes," said Dr. Foreman, "but she was tested for infections and was negative."

"We need a liver biopsy," House said.

"She's not stable enough right now," Chase said, "we start poking instruments in her, and she'll have another bout of severe tachycardia."

"She's already had a liver biopsy at the other hospital, is there any chance we can get it?" Susan asked.

"I'll make the call," Taub said as he got up to leave the room.

Dr. House ordered more blood pulled, but didn't specify what tests he wanted run and ordered a fresh CT scan. Chase and Foreman left to ready the CT scanner and Susan grabbed her phlebotomy tray. She went to the patient's room and was stopped by Nurse Jeffrey.

"You can't go in there, ICU is off limits to lab techs," he said.

"Dr. House has ordered blood drawn," Susan explained.

"I'll do it for you, what tests does he want run?" he asked.

"He didn't say," Susan replied.

"I find it hard to believe that you would come up here to pull blood not knowing what tests he wanted to run," Jeffery said.

"There isn't a lot he can do with the patient until she stabilizes, so I think he's planning ahead. I was planning on pulling a rainbow to make sure I had all the bases covered," Susan explained.

"A rainbow?" Jeffrey asked.

Susan couldn't believe that he didn't know what a rainbow was. "You know, one of each tube type. It's called a rainbow because each stopper color on the tube is different." Susan handed Jeffery the tray and as he started through the door, Susan added, "Give me her catheter bag too." Ten minutes later Nurse Jeffrey emerged with the blood tubes and the catheter bag and handed them over to Susan.

"You actually like working for Dr. House?" he said.

"Sure, why not? His cases are interesting and I love his sense of humor" she said.

"To each their own," Jeffrey said as he turned back to the nurse's station.

Susan went back to the lab and prepared the specimens for storage. Each tube type required a different work up to keep the specimen viable. She also stored the urine for future use. She wanted to be as helpful as possible and wished she had a better feel for the tests he was going to require. She decided to go ahead and run some basic labs to give the team some information while they were trying to decide what diagnostic tests to run. A fresh CBC was in order and since they would need as much information as possible, she decided to not only run the blood through the flow cytometer, but to also do a manual differential count. It never hurt to look through the scope. She prepared the slide and as she was counting, a courier walked in her lab. "Are you Susan Watkins?" he asked.

"Yes, can I help you?" Susan answered.

"I have a delivery for you," the courier said.

Susan signed for the package and opened it. It was the liver biopsy and slides from the referring hospital. Susan looked at the wax block of tissue – it was a very thin piece of tissue. They had sent three H&E stained slides, but it was apparent that the histotech had cut quite a few sections from the biopsy. She wondered where those slides were. She decided to call the histology lab at the other hospital directly. She spoke with the lab supervisor and he remembered pulling the block for them. "This block is in pretty bad shape and looks like it's had a lot of sections taken from it, but we only have three slides. Do you have any of the other slides available, stained or unstained?"

"No, I'm sorry we don't," the supervisor said. "Several of our techs are sitting for their ASCP exams and they needed liver as one of the tissues for their exams, so I'm afraid they used most of the material," she went on to explain.

Dr. Taub walked in the lab just as Susan was hanging up the phone. She handed the block to him to look at. "There isn't much left here," he said. "Can you do anything with it?" he asked.

"She let the students use the material for their ASCP exams," Susan said. "I'm going to re-embed the tissue and see what I can section off; if I'm lucky I can get 4-5 more sections from it. It's really thin."

"Good luck," Taub said as he walked out the door. Susan finished the CBC count and then took the block to the histology lab to re-embed the tissue and section what she could from it. By the time she was done, she had five unstained slides and the tissue was depleted. She hoped it would be enough. She decided to look at the H&E stained slides from the other hospital to make sure she could use her sections for more definitive testing should Dr. House require special stains to be ran. Placing the first slide on the microscope and adjusting the focus, Susan looked at the H&E stained slide. "Oh, you have got to be kidding." She said out loud to herself with dismay.

"About what?" startling Susan and causing her to bump her forehead into the microscope. She turned, it was Dr. Wilson

"Would you quit doing that to me?" she said as she rubbed her head. "I need to buy you some shoes that have a squeak in them or something. I never hear you come in the lab," She said.

Dr. Wilson grinned, "What are you looking at?" he asked.

"A liver biopsy," she answered.

Dr. Wilson looked in the scope, "Susan, this is the worst tissue section I've ever seen," he said.

"It's not mine; it's from the referring hospital for our patient." Susan quickly replied with her hands defensively up in front of her. I was hoping to use these slides so that I could save the sections I cut for IHC stains or whatever else Dr. House might want for them, but I'm going to have to use one of them for an H&E stain. You can't diagnose anything from that; this tissue must be at least 5 cell layers thick. If this is their typical work, I really feel sorry for their pathologists."

Susan ran an H&E stain on one of the slides from the liver biopsy, photographed the tissue at several power settings in the microscope and emailed the images to Dr. House. It wasn't going to be much help to him, there was very little fibrosis, so whatever was causing the issue affected the liver, but the liver itself wasn't the cause.

By the next differential, the patient had continued to decline. Her white hemoglobin and her white count continued to drop and her fever raged unchecked despite every attempt to lower it to normal levels. Dr. House ordered her spleen removed and told Dr. Chase to do a bone marrow biopsy while he had her under. Her spleen was huge; this had to be cancer and Dr. Wilson was called in for a consult. Dr. Wilson agreed that cancer was the best candidate, but without knowing what kind of cancer it was, there was no way they could treat. "We need to assess the spleen," he said. "Susan, go to the pathology department and pull the tissue from the grossing department. We need immunohistochemistry stains for S100 and kappa/lambda.

"Before you go," Foreman interrupted, "she's showing indications of renal failure, so run an immunoelectrophoresis on the urine and if it is positive, follow-up with a FISH study for plasma cell abnormalities."

Susan wrote everything down and left to go to the lab. Now she was worried. Up to this point, the lab work she had done was standard stuff, now they were asking her to do some very specialized testing. The histology studies on the spleen didn't worry her, so she started with that. She prepared the tissue and took it to the tissue processor in the histology lab. The histotechs were getting ready to start another overnight run, so she added her tissue cassettes to their batch and asked them to let her know when the tissue was ready to be embedded. As she walked back to the lab, she thought about Foreman's request. She had the equipment to run the electrophoresis gel on the urine specimen, but if it was positive she didn't know how she was going to handle the FISH study. It had been over 5 years since she had done a FISH analysis and she had only done it once or twice and _that_ was in a research setting. A patient wasn't depending on the results, so there wasn't any pressure. Susan prepared the gel and put the specimens in the wells. She started the gel and set it up for an overnight run. The gel should finish early the next morning. It was getting late and having done everything she could do, she gathered her things and started out the door. Before she left, she stopped by Dr. Wilson's office and knocked on the door. Wilson looked up from his paperwork, "Headed out?" he asked.

"Yes," she answered hesitantly.

"What's wrong?" Wilson asked noting the look on her face

"Nothing," she answered pensively and left for home.

That night Susan slept fitfully. Up to now, most of the tests Dr. House's team had her run were fairly standard tests, but a FISH study was outside the normal parameters for standardized testing. It had been so long since she had done one and she didn't have the right equipment. She really didn't want to disappoint the team and more importantly didn't want to screw up a test that a patient was depending upon. Susan woke up at 4:00am and couldn't go back to sleep. She decided she may as well go on into work. She thought about the case and by the time she was on her way to work, she had made up her mind.

When she got to the lab, she analyzed the gel. It was positive, so the FISH study needed to be done. She looked through the medical school directory and found the appropriate number. It was too early to call, so she went down to histology to get the spleen tissue out of the tissue processor. She embedded and sectioned it while she was there since she didn't have her own histology equipment. Gathering the blocks and slides, she went back to her lab to stain the slides per Dr. Wilson's request. By the time she had the slides incubating with the antibodies; it was late enough to make her call. After talking to the research director, she left the lab.

It was 10:00. Dr. House walked into the conference room where the team and Dr. Wilson were gathered. Susan was missing. "Where's Susan?" House asked.

"We don't know; she's not in the lab and she's not answering her phone," said Dr. Wilson.

"She's here somewhere," offered Chase, "I saw her jeep in the parking lot when I came in this morning."

"What's going on with our patient?" House asked.

"She's continuing to decline," Foreman said. "Overnight we had to put her on a ventilator, it's unlikely she's going to survive much longer if we can't find a way to treat her, we need those test results now."

As if hearing Dr. Foreman, Susan rushed in the conference room, "I'm sorry, I'm working as fast as I can," she said as she handed the results she had gathered so far to Dr. House.

"Dr. Wilson, you're S100 and kappa/lambda slides are ready for you to look at in the lab, but I can tell you what I saw if you don't want to wait to look for yourself."

"I'll look, but tell me anyway," he said. "The S-100 stain is shows histiocyte proliferation as you expected and the kappa/lamba stains show a polytypic population, so I'm not sure that either of these stains is giving you the answer you need. Dr. Foreman, you're urine electrophoresis was positive for monoclonal protein and I'm still working on the FISH study. It'll be late this afternoon before I'm done with it." House wrote the results on the white board while he pondered the results.

"What about macrophage activation syndrome?" asked Taub.

"It fits," said House, "perform a plasmaphereis and start her on steroid therapy."

The team left to start the treatment. Susan turned to leave when she heard Dr. Wilson, "Susan, stay here for a minute. Where did you go? We've been looking for you all morning."

"I'm sorry," Susan said. "I was worried about the FISH study, so I went to get help. I forgot my phone in the lab."

"You don't know how to do a FISH study?" House asked. Susan shook her head, she knew she had disappointed them, "It's been a long time since I had done one and that was in a research setting, I didn't want to risk delaying the results with a mistake when the patient is so critical."

"So you left without telling anybody what you were doing." Dr. Wilson said.

"I'm sorry, I wasn't thinking about that, I just wanted to get the testing done," Susan explained. An alarm went off and Susan pulled a lab timer out of her pocket. Looking at it she said, "I need to get back, it's time for the next incubation step," Dr. House nodded her dismissal and Susan left.

"I wonder who she's gotten to do the FISH study?" Wilson mused.

"No clue," said House.

"I know you're disappointed, but I think she did the right thing," Wilson said.

"I'm not disappointed," said House, "I don't expect her to know everything. This is just the first time she's not been able to do a procedure we've asked her to do."

The patient continued to deteriorate, her hemoglobin and platelets continued to decrease. Despite aggressive treatment, her fever continued to rage. By the time Susan had the results from the FISH analysis, the patient had died. Susan walked into a very somber conference room. Dr. House was standing and staring out the window and the fellows were all sitting silently. "What's wrong?" Susan asked.

"We lost the patient," Taub replied "We ran out of time before we were able to make a diagnosis. The patient is in autopsy right now."

Not saying anything, Susan set the results from the FISH analysis on the table and left the room. She didn't go back to the lab, instead she headed outside.

There was a jogging park not far from the hospital and she walked over to a picnic table and sat down staring blankly in the distance, tears falling silently down her cheeks. She didn't know how long she had been sitting there and she was starting to feel the cold when she felt a presence and looked to her left. She watched as Dr. House sat down next to her. He didn't say anything as he gently slipped her coat over her shoulders. Finally Susan said quietly, "I'm sorry."

"Not your fault," he said. "Sometimes we lose patients."

"I know, but this one was my fault," Susan choked as she tried to hold back the tears.

"No, it wasn't." House said.

"If I would have remembered how to run that test, we would have had the results faster," Susan said.

"And it wouldn't have made any difference. The patient still would have died." House explained. "She had intravascular lymphomatosis. It's extremely rare and very progressive so that most of the time it is diagnosed at autopsy." House explained. House fell silent while Susan processed what he had told her. Finally he continued, "Susan, you are one of the most knowledgeable lab techs I've ever known, but I don't expect you to know how to do everything. I do however expect you to take initiative to find a way to get the tests we need done when you don't know how to do them, and that's exactly what you did. I'm proud of you." Susan looked over at him still with tears in her eyes and nodded her acknowledgement and thanks. He paused and then said, "OK, that's enough hand holding. It's cold out here, let's go back inside." Susan and House walked back to the hospital together in silence.


	9. Chapter 9

Chapter 9

The next morning there was a note on her lab bench; "Wilson's at 10." Susan began her daily maintenance and QC routine before heading to Dr. Wilson's office. She knocked, "Come on in," she heard Dr. Wilson say. Dr. House was in the office sitting on the couch and Wilson motioned for her to sit in the chair in front of his desk. He had a stack of papers in front of him. "First things first, your lab tests from your needle stick have come back clean. You need to sign this form saying you've been informed of the results for the safety department." Susan signed the form and then looked questioningly at Dr. Wilson, waiting for whatever came behind "first things first." Wilson took the next set of papers in his hand, "It's time for your biannual review." He started to read it to her and then thinking better of it, just handed the form over for her to look at herself.

It was a standard form with a lot of questions and answers most of them marked "Meets expectations" with a few "Exceeds expectations" and one "Needs improvement." That one was next to the question about attitude and temperament. Well, that was no surprise; she knew she needed to work on that area. There was a section for comments and there were two sets of handwriting.

"_Susan is very knowledgeable toward laboratory techniques and has a commendable work ethic. She has taken initiative to find ways around testing limitations in the lab to make sure the patient is able to have the tests he or she needs for diagnosis. Examples include utilizing specimens obtained from other laboratories and seeking expertise outside the hospital for specialized testing."_

The second comment was in different hand writing, it simply said, _"No issues."_

Susan kept her face neutral as she signed the document and handed it back to Dr. Wilson. Finally he picked up the last set of papers, "Your proficiency results have come in," he said handing them over. Susan looked through each page, there was one 'unacceptable' value for one of the specimens under cholesterol so she'd have to investigate to see what the issue was, more than likely it was just a transposition error between the print out and when she submitted the results; but regardless she had passed the hematology, chemistry and immunology portions of the PT exam with flying colors. As she looked over the Microbiology PT results and found she had identified all the unknowns correctly. This was a huge relief. She signed the result form and asked if there was anything else. Dr. Wilson shook his head no and Susan got up to leave.

As she shut the door behind her, she allowed herself to smile, _"No issues" _it had said. The last two weeks had been full of tests, professional, personal and emotional and some of them had been very trying. She had passed all her tests, but one result meant more to her than any of the others. _"No issues."_ She thought again as she walked back to her lab, smiling all the way.


End file.
